New devices to treat the injured on the battlefield

US Army Institute of Surgical Research finding ways to save more lives

With life-saving equipment strapped to their backs, they rush in to help fallen comrades on the frontlines, but one of the items combat medics carry is something that's stayed pretty much the same for centuries. Now, two new devices are in development that could help treat troops on the battlefield.

Combat medics-in-training learn how to save lives, and a simple tool helps them do just that.

"About three thousand U.S. military casualties have been saved with the tourniquet since the beginning of the war," explained John Kragh, MD, ISR Tourniquet Specialist at the U.S. Army Institute of Surgical Research.

While the materials have improved, Kragh says the tourniquets haven't changed in 2,000 years. Kragh and Jose Salinas want to change that.

We call it the intelligent tourniquet,” said Jose Salinas, PhD, Manager for the Comprehensive Intensive Care Research at the U.S. Army Institute of Surgical Research.

The intelligent tourniquet has a pump and sensor system that can be controlled wirelessly, activated by clicking a button.

"It can determine how much pressure it needs based on the limb to stop blood flow. it will always maintain accurate pressure," said Salinas.

It could be carried by medics or even built into uniforms.

The wireless vital sign monitor weighs just one pound.

“It’s extremely portable," added Salinas.

It keeps track of basic vitals like heart rate and blood pressure. Wirelessly connect it to a laptop, tablet or smart phone and you get more detailed readings.

“With this system you bring the power of a full vital signs monitor to the frontlines,” said Salinas.

The wireless vital sign monitor is FDA cleared and is even available for civilian EMS use, but is not yet on the battlefield. Salnias hopes to have the system available for deployment within the next two years. As for the intelligent tourniquet, it is still in the early prototype stage.

Additional Information:

BACKGROUND: Research at the U.S. Army Institute of Surgical Research (ISR) on extremity injuries in 2004, has led to improving tourniquet devices to all U.S. troops deployed to combat by the Department of Defense in 2005. This resulted in a reduction in battlefield deaths from limb exsanguinations. Research has shown that soldiers who were wounded, incapacitated, and were in a location where a field medic could not reach them died. A tourniquet is used to control bleeding by constricting the limb above the wound. It should only be used if the bleeding is life-threatening. Today, the same tourniquets that save lives in the battlefield are used by paramedics to save lives of people with life-threatening, non-combat injuries.. For example, a paramedic team from the Emergency Medical Service in Schertz, Texas, used the Combat Application Tourniquet (CAT) on a motorist whose leg was amputated by another driver when he was changing a flat tire on the side of the road. (Source: www.combattourniquet.com)

INTELLIGENT TOURNIQUET (iTK): The iTK was first developed through a partnership between the ISR and Athena GTX. Scientists developed it because they wanted to integrate the tourniquet concept with computer technology. It is an air bladder, sensor suite, and wireless computer control system that is all compacted into the existing tourniquet to provide automated control of tourniquet activation based on patient sensor data or at the direction of a nearby medic through a wireless connection to the intelligent tourniquet. It is still in the prototype stages, but researchers are hoping to be able to have a system that they can test on patients in a few years. The iTK is fitted with a computer the size of a pack of cards. It can be activated or deactivated at the point of injury by the wounded warrior or remotely from a different location. The computer can also monitor the patient’s vital signs and interventions. For example, if the unit notices the blood pressure of the patient is starting to stabilize itself, then the computer system would tell the control units to loosen the tourniquet and profuse the limb if it needs to be. Researchers want to eventually fit battle uniforms with the iTK along with sensors that would detect a blast going off around the warrior and automatically deploy. If it activates and is not needed, then the warrior could push a button on the computer to deactivate it. (Source: www.usaisr.amedd.army.mil)

WIRELESS VITAL SIGNS MONITOR: The FDA approved the Wireless Vital Signs Monitor (WVSM), which was designed by a partnership between the U.S. Office of Naval Research and Athena GTX. It is a small device that measures and records a patient’s electrocardiogram, pulse oximeter, heart rate, and non-invasive systolic, diastolic, and mean blood pressures. The information can be transmitted to a medic’s laptop, electronic tablet, or smartphone where it calculates even more patient information; such as, trends, pulse pressure, and complexity indices. This device has ISR technology to provide users with information on the patient’s condition, not just from actually seeing the patient. The WVSM is strapped on to a patient’s arm or leg and it captures all vital signs from the point of injury. It is capable of transmitting and downloading information to a hospital’s emergency department monitoring system. The WVSM tells the medic when a patient’s condition is getting worse even though there may not be any physical signs. The current WVSM uses electronic waves to connect the pulse oximeter that attaches to a patient’s finger and the electrodes that are placed on the chest. They could get cut or damaged during treatment. Researchers are hoping that the new version in clinical trials will eliminate these wires. (Source: www.usaisr.amedd.army.mil)

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